Hispanic outreach fuels health care push

Conn. Health I-Team Writer

Published 1:00 am, Tuesday, October 1, 2013

Milagrosa Seguinot knows educating Hispanics who are uninsured and underinsured about the new options available at Access Health CT -- the health insurance marketplace that opens for business Tuesday -- presents a unique set of problems.

But with one in four Hispanics lacking coverage, Seguinot, community health worker project coordinator for Southwestern Area Health Education Center, in Trumbull, is up for the challenge. Connecticut's Hispanics represent the fastest-growing, youngest and poorest segment of the state's population.

Estimates of Connecticut's uninsured vary. Approximately 344,000 people lack health insurance in Connecticut and 65 percent of the state's uninsured are minorities, according to data being used by Access Health. Estimates released by the U.S. Census Bureau in September, however, put the uninsured at 284,000.

Between 100,000 to 130,000 state residents are expected to gain coverage in 2014 through federal health care reform initiatives. Access Health reported that about 7,000 state residents have expressed interest in the program thus far.

Yet getting Hispanics to enroll for coverage poses many challenges, said experts, who cited language and cultural barriers, a lack a familiarity with commercial insurance, fear surrounding immigration issues, and an inability to navigate a complex health care system as some of the obstacles they expect Spanish-speaking residents to encounter. Some advocates also worry the $6,000 grants awarded to assister organizations won't be sufficient to sustain Hispanic outreach during the six-month enrollment period.

The Hispanic Center of Greater Danbury is among the estimated 300 "in-person assister" organizations poised to help Hispanics and others access new coverage through the Affordable Care Act. At least a third of the in-person assisters selected by Access Health speak Spanish.

Andrea Contreras, an assister at Danbury's center, said she worries about "health literacy" because many Hispanics have limited reading skills and little or no experience with commercial insurance.

"We have many uninsured Latinos who come to the center for help," Contreras said. "They don't know much about premiums, deductibles and those types of details. There is a lot of education to be done. We need to teach them everything about health insurance."

The assisters are working with six regional "navigator" organizations that will coordinate efforts and offer technical, cultural and linguistic support. The Trumbull health education center where Seguinot works is Fairfield County's navigator organization.

A Puerto Rican native and longtime community worker who has lived in Bridgeport for 29 years, Seguinot said there's a learning curve for everyone when it comes to the health exchange and Hispanics are no different.

"Even Hispanics from other countries who have lived here for a long time are not familiar with how the system works because they have never had to deal with insurance," she said. "They don't know what to do. It's our responsibility to present the information using simple language that they understand so they can make their own decisions."

Access Health begins selling policies to consumers today, with coverage effective Jan. 1, 2014. Residents with moderate and low incomes are eligible for tax credits and subsidies to offset the costs. In addition, some individuals will be eligible for Medicaid for the first time under newly expanded eligibility guidelines.

Efforts by Access Health to reach Hispanics include hosting a series of "Spanish friendly" Healthy Chats across the state, producing a television series called Mercado De Salud with Univision, and attending community events such as the Puerto Rican Parade. Consumers can view a Spanish version of the Access Health website. Assisters and navigators also received training on cultural competency.

"This is an important opportunity for those who are most disenfranchised," said Patricia Baker, president and chief executive officer of the Connecticut Health Foundation, which awarded Access Health a $125,000 grant to support grass-roots education and enrollment, with a focus on increasing coverage in communities of color.

"We need a culturally and linguistically competent and sensitive approach to ensure that Latinos get their fair share," Baker said. "Having trusted people who understand their culture and language will be critically important."

Yet with close to 28 percent of Connecticut's Hispanics living in poverty, some community advocates fear health insurance will remain financially out of reach for many even with tax credits and subsidies.

Among the hardest hit are individuals who fall between the cracks -- they earn too much to qualify for Medicaid, but not enough to receive tax credits and subsidies to shop at Access Health.

Some Hispanic families may think twice about exploring the new coverage options because they don't want to discuss immigration matters, said Yanil Terón, executive director of Center for Latino Progress in Hartford. "They're concerned about coming forward," she said. Undocumented immigrants cannot reap the law's benefits, but their U.S.-born children can apply for HUSKY, the state's subsidized health program.

Consumers must provide information about citizenship status, income and other matters to determine eligibility for Medicaid or subsidized private coverage with Access Health, but conversations remain confidential. "There is no punitive immigration follow-up. That is 100 percent not part of the enrollment process," added Jason Madrak, chief marketing officer for Access Health.

"Everybody was excited and ready to go live. The room was full of energy," said Seguinot, of a recent meeting between the assister organizations and Southwestern Area Health Education Center. "I feel very positive about this project. We are making history."